American Geriatrics Society Position Statement: Advancing the Healthcare of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and More Older Adults

In the decade since the American Geriatrics Society (AGS) released a position statement on Care of Lesbian, Gay, Bisexual, and Transgender Older Adults, we have seen significant progress toward achieving equal health and civil rights for lesbian, gay, bisexual, transgender, queer, intersex, and more (LGBTQI+) individuals. Advances have included increased visibility, legalization of same-sex marriage, and legal protections against discrimination. Even so, for LGBTQI+ older adults, substantial gaps, fears of discrimination, and legal uncertainty persist. Older LGBTQI+ adults experience the intersection of ageism with structural discrimination associated with their sexual and gender minority status-homophobia and transphobia. These experiences occur in many sectors of society, including health care, exacerbating disparities, impacting social determinants of health, and leading to accumulated discrimination across time. The potential for setbacks to progress remains as lawsuits are filed and policymakers consider legislation that would roll back rights at the state and federal levels. Recognizing this evolving landscape, AGS established a writing group to update the 2015 position statement with the goals of supporting progress on eliminating discrimination against LGBTQI+ older adults in healthcare and supporting integration of evidence-based approaches to caring for these older adults across care settings. By providing recommendations on inclusive education, policy reform, and focused research, AGS aims to promote the health, independence, quality of life, and dignity of LGBTQI+ older adults. Within education, we recommend standardized training for all healthcare staff, with specialized instruction for clinicians caring for LGBTQI+ older adults. On the policy front, we emphasize maintaining nondiscriminatory measures, supporting chosen families in caregiving, promoting completion of advance directives, and collecting and ensuring privacy of sexual orientation and gender identity (SOGI) information. Research priorities include continuing to advance SOGI data collection, understanding mechanisms driving disparities, developing health promotion interventions, and furthering research into long-term services and supports.